Am I unhealthy? BMI says I'm obese..
Replies
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I'm not saying conditions secondary to obesity or the significant health implications obesity has isn't an issue or unimportant at all. Or that bmi isn't an easy, straight forward tool that shouldn't be used. Or that people's feelings should be spared by not telling them they are much more predisposed to chronic health conditions because they are obese, over weight, morbidly obese. I simply answered the question. Yes, the label, for me, was an issue and sometimes, it's hard, telling patients that have NO idea they are actually morbidly obese, not Just "overweight" after using the BMI tool as an assessment. I've strayed way to far from the OP's post by discussing other issues related to BMI.
I’m sure it’s hard telling patients they have cancer! What does that have to do with anything? It’s something that sometimes needs to be done, and there’s no reasonable way to soft-peddle it and still get the information across with the correct amount of urgency.13 -
I just went up from 20.5 to 21.55 on that new BMI calculator. Range being 41.2-55.68 kilos, which sounds about right for my height. There are women with a much smaller frame than me, who could be perfectly ok at 41 kilos. I could stand losing a few myself (carry some fat round hips and thighs).0
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BMI was never meant to be conclusive as a singular metric. Saying it falls down as a singular metric doesn't disprove it. That's like saying the front leg on your tripod is useless because it won't hold up your camera on it's own.
BMI was meant to be a general guideline statistically and then taken into consideration along with other health indicators to get a complete picture on the individual level. You look at BMI, weight, BF %, waist measurement, waist to hip ratio, blood pressure, A1C, heart rate, lung sounds, etc and come to a conclusion. There are situations where one or two of those metrics might not be optimal but the rest are fine so you don't have to worry about it.
It's also important to remember that "health" is not a yes or no proposition, it's a sliding scale. There are myriad variables that make you more or less likely to get myriad conditions. All the BMI range is trying to do, is get you into a statistically lower risk category. Just like there are lifetime smokers who get to 90 and never get cancer, or people who drunk drive and don't get in an accident, you can live outside the healthy BMI range and be healthy. You just have a statistically higher risk, based on demographic data.
I'd say if you are above the healthy BMI range, and don't want or think you need to get lower, focus on the other metrics. If the other metrics are also out of line, then you might want to reconsider your perception of health, or you might be fine just consciously accepting the additional risk you are taking on. You get to choose, though I suppose your insurance company might make you pay for that choice.17 -
Recent had a physical for a new insurance policy. The nurse calculated my BMI and I guess I'm obese... lol
We both had a good laugh3 -
BMI is only a general guideline. At the same time, it's the exceptions that make the rule right?
If it states you are obese I'm afraid you can take that as true. Or you'd be at least in the higher range of Overweight.
You've already lost a lot of weight, clearly what you're doing is working, so keep at it!4 -
rheddmobile wrote: »I'm not saying conditions secondary to obesity or the significant health implications obesity has isn't an issue or unimportant at all. Or that bmi isn't an easy, straight forward tool that shouldn't be used. Or that people's feelings should be spared by not telling them they are much more predisposed to chronic health conditions because they are obese, over weight, morbidly obese. I simply answered the question. Yes, the label, for me, was an issue and sometimes, it's hard, telling patients that have NO idea they are actually morbidly obese, not Just "overweight" after using the BMI tool as an assessment. I've strayed way to far from the OP's post by discussing other issues related to BMI.
I’m sure it’s hard telling patients they have cancer! What does that have to do with anything? It’s something that sometimes needs to be done, and there’s no reasonable way to soft-peddle it and still get the information across with the correct amount of urgency.
Of course you're right. Likening telling patients they are fat or telling them they have CA though render completely different feelings, for me. I did Mean to imply, being told what sub group people sit in using BMI was important to educate the patient on the Increase risk of Co-morbidities and the severity being obese has on their health, I never said it wasn't. Just that from a personal psychological level, the context being bmi, a label and the question I was asked regarding how I felt knowing I was actually morbidly obese, I have empathy due to the way I felt when I did my BMI and i sat at morbidly obese, i just thought I was fat/over weight.2 -
I think it depends on how you feel & how your health is. I’m 5’3” and was up to 163. I’ve always done intense workouts 5x per week and my numbers at the doctors were immaculate ( perfect blood pressure, cholesterol, etc). While there didn’t appear to be a medical reason to lose weight, I just wasn’t feeling great about how I looked in my clothes. At 163, my clothing size was a 8-10- I think a lot has to do with where you carry your weight- I’m pretty hourglass-shaped. I’m (very slowly) losing weight using mfp. I’m at 148 now and feel much better getting dressed in the morning, including wearing form fitting gym clothes. I plan to lose 10 more pounds. But this is definitely vanity for me vs. a health issue.2
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Lillymoo01 wrote: »There is a different BMI type calculation which uses height to the power of 2.5. Back in the day when BMI was invented powers of non-integers were hard to calculate, square is much easier.
The equivalent calculation is 1.3 * weight / height ^ 2.5, this gives a number about 0.8 lower than the normal calculation for my body, I'm 183 cm tall.
People can read about the new calculation here:
https://people.maths.ox.ac.uk/trefethen/bmi.html
There are a number of other indexes I've come across over the years, probably the most sophisticated which uses the height difference between shoulders and hips, and other measurements.
This is my new weight range according to this.
Your new BMI healthy range is
38.57 to 52.11 kgs.
There is no way I would consider myself healthy at under 40 kgs! I feel more comfortable with the current range between 41.5 and 55 kg, especially as I stop my periods under 42 kg.
Which is why I really don't think that BMI should be used for individuals, as this graph shows
The scatter graph shows that people of the same BMI can have vastly different body fat percentages.
If the scatter graph is accurate, then the implication is that for women of BMI just over 30 (where OP is), it's quite unusual to have a BF% under 35%, which is at or (more commonly) above the BF% considered the healthy range for a 23-year-old, in most BF assessment schemes. Someone who's been training hard for a year is unlikely to have gained enough muscle mass from that short time to be an extreme outlier. Possible? Maybe. Likely? No.
In general, the scatter graph would seem to suggest that BMI often under-diagnoses excessive body fat in women, considering them to be in a normal BMI range when they actually have an above-optimal BF%.16 -
Lillymoo01 wrote: »There is a different BMI type calculation which uses height to the power of 2.5. Back in the day when BMI was invented powers of non-integers were hard to calculate, square is much easier.
The equivalent calculation is 1.3 * weight / height ^ 2.5, this gives a number about 0.8 lower than the normal calculation for my body, I'm 183 cm tall.
People can read about the new calculation here:
https://people.maths.ox.ac.uk/trefethen/bmi.html
There are a number of other indexes I've come across over the years, probably the most sophisticated which uses the height difference between shoulders and hips, and other measurements.
This is my new weight range according to this.
Your new BMI healthy range is
38.57 to 52.11 kgs.
There is no way I would consider myself healthy at under 40 kgs! I feel more comfortable with the current range between 41.5 and 55 kg, especially as I stop my periods under 42 kg.
Which is why I really don't think that BMI should be used for individuals, as this graph shows
The scatter graph shows that people of the same BMI can have vastly different body fat percentages.
If the scatter graph is accurate, then the implication is that for women of BMI just over 30 (where OP is), it's quite unusual to have a BF% under 35%, which is at or (more commonly) above the BF% considered the healthy range for a 23-year-old, in most BF assessment schemes. Someone who's been training hard for a year is unlikely to have gained enough muscle mass from that short time to be an extreme outlier. Possible? Maybe. Likely? No.
In general, the scatter graph would seem to suggest that BMI often under-diagnoses excessive body fat in women, considering them to be in a normal BMI range when they actually have an above-optimal BF%.
I struggle with the accuracy of this as well. If I am reading it correctly it is really saying that the average female with a BMI of 20 has a body fat percentage of close to 30% with variations between 20% and 40%. That just does not seem correct.7 -
BMI was never meant to be conclusive as a singular metric. Saying it falls down as a singular metric doesn't disprove it. That's like saying the front leg on your tripod is useless because it won't hold up your camera on it's own.
BMI was meant to be a general guideline statistically and then taken into consideration along with other health indicators to get a complete picture on the individual level. You look at BMI, weight, BF %, waist measurement, waist to hip ratio, blood pressure, A1C, heart rate, lung sounds, etc and come to a conclusion. There are situations where one or two of those metrics might not be optimal but the rest are fine so you don't have to worry about it.
It's also important to remember that "health" is not a yes or no proposition, it's a sliding scale. There are myriad variables that make you more or less likely to get myriad conditions. All the BMI range is trying to do, is get you into a statistically lower risk category. Just like there are lifetime smokers who get to 90 and never get cancer, or people who drunk drive and don't get in an accident, you can live outside the healthy BMI range and be healthy. You just have a statistically higher risk, based on demographic data.
I'd say if you are above the healthy BMI range, and don't want or think you need to get lower, focus on the other metrics. If the other metrics are also out of line, then you might want to reconsider your perception of health, or you might be fine just consciously accepting the additional risk you are taking on. You get to choose, though I suppose your insurance company might make you pay for that choice.
I think whoever invented BMI is stalking this topic and hitting “disagree” with any comment that doesn’t worship BMI.
Your comment was perfectly reasoned on all fronts. Anyone disagreeing is either a willful troll or someone who is not qualified to sit at the adult table.
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BMI was never meant to be conclusive as a singular metric. Saying it falls down as a singular metric doesn't disprove it. That's like saying the front leg on your tripod is useless because it won't hold up your camera on it's own.
BMI was meant to be a general guideline statistically and then taken into consideration along with other health indicators to get a complete picture on the individual level. You look at BMI, weight, BF %, waist measurement, waist to hip ratio, blood pressure, A1C, heart rate, lung sounds, etc and come to a conclusion. There are situations where one or two of those metrics might not be optimal but the rest are fine so you don't have to worry about it.
It's also important to remember that "health" is not a yes or no proposition, it's a sliding scale. There are myriad variables that make you more or less likely to get myriad conditions. All the BMI range is trying to do, is get you into a statistically lower risk category. Just like there are lifetime smokers who get to 90 and never get cancer, or people who drunk drive and don't get in an accident, you can live outside the healthy BMI range and be healthy. You just have a statistically higher risk, based on demographic data.
I'd say if you are above the healthy BMI range, and don't want or think you need to get lower, focus on the other metrics. If the other metrics are also out of line, then you might want to reconsider your perception of health, or you might be fine just consciously accepting the additional risk you are taking on. You get to choose, though I suppose your insurance company might make you pay for that choice.
i totally agree with that, however several of my doctors and a nurse practitioner doesn't seem to have gotten the memo. all of them strongly believe in BMI as the one and only metric they're concerned with. this was a problem for me when i was a bodybuilder with some fat on me, and is one of the reasons i kept changing doctors.
my current doctor actually seems to agree with what you just wrote, btw.5 -
Lillymoo01 wrote: »Lillymoo01 wrote: »There is a different BMI type calculation which uses height to the power of 2.5. Back in the day when BMI was invented powers of non-integers were hard to calculate, square is much easier.
The equivalent calculation is 1.3 * weight / height ^ 2.5, this gives a number about 0.8 lower than the normal calculation for my body, I'm 183 cm tall.
People can read about the new calculation here:
https://people.maths.ox.ac.uk/trefethen/bmi.html
There are a number of other indexes I've come across over the years, probably the most sophisticated which uses the height difference between shoulders and hips, and other measurements.
This is my new weight range according to this.
Your new BMI healthy range is
38.57 to 52.11 kgs.
There is no way I would consider myself healthy at under 40 kgs! I feel more comfortable with the current range between 41.5 and 55 kg, especially as I stop my periods under 42 kg.
Which is why I really don't think that BMI should be used for individuals, as this graph shows
The scatter graph shows that people of the same BMI can have vastly different body fat percentages.
If the scatter graph is accurate, then the implication is that for women of BMI just over 30 (where OP is), it's quite unusual to have a BF% under 35%, which is at or (more commonly) above the BF% considered the healthy range for a 23-year-old, in most BF assessment schemes. Someone who's been training hard for a year is unlikely to have gained enough muscle mass from that short time to be an extreme outlier. Possible? Maybe. Likely? No.
In general, the scatter graph would seem to suggest that BMI often under-diagnoses excessive body fat in women, considering them to be in a normal BMI range when they actually have an above-optimal BF%.
I struggle with the accuracy of this as well. If I am reading it correctly it is really saying that the average female with a BMI of 20 has a body fat percentage of close to 30% with variations between 20% and 40%. That just does not seem correct.
Good point: I share your skepticism about the graph, for a variety of reasons.
The beauties of bringing in something without any sourcing identified, eh?
But if it were (is?) accurate, there are apparently a bunch of women with normal BMI but excessive body fat, not exactly fabulous support for the concept that it's OK (for women) to ignore BMI if it says they're overweight/obese on the grounds of BMI inaccuracy.
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Lillymoo01 wrote: »Lillymoo01 wrote: »There is a different BMI type calculation which uses height to the power of 2.5. Back in the day when BMI was invented powers of non-integers were hard to calculate, square is much easier.
The equivalent calculation is 1.3 * weight / height ^ 2.5, this gives a number about 0.8 lower than the normal calculation for my body, I'm 183 cm tall.
People can read about the new calculation here:
https://people.maths.ox.ac.uk/trefethen/bmi.html
There are a number of other indexes I've come across over the years, probably the most sophisticated which uses the height difference between shoulders and hips, and other measurements.
This is my new weight range according to this.
Your new BMI healthy range is
38.57 to 52.11 kgs.
There is no way I would consider myself healthy at under 40 kgs! I feel more comfortable with the current range between 41.5 and 55 kg, especially as I stop my periods under 42 kg.
Which is why I really don't think that BMI should be used for individuals, as this graph shows
The scatter graph shows that people of the same BMI can have vastly different body fat percentages.
If the scatter graph is accurate, then the implication is that for women of BMI just over 30 (where OP is), it's quite unusual to have a BF% under 35%, which is at or (more commonly) above the BF% considered the healthy range for a 23-year-old, in most BF assessment schemes. Someone who's been training hard for a year is unlikely to have gained enough muscle mass from that short time to be an extreme outlier. Possible? Maybe. Likely? No.
In general, the scatter graph would seem to suggest that BMI often under-diagnoses excessive body fat in women, considering them to be in a normal BMI range when they actually have an above-optimal BF%.
I struggle with the accuracy of this as well. If I am reading it correctly it is really saying that the average female with a BMI of 20 has a body fat percentage of close to 30% with variations between 20% and 40%. That just does not seem correct.
My viewing of the graph has female BMI of 20 at between 25 and 35 percent.
I found this using Google Images search of BMI vs body fat, there are a number of graphs available and you can usually read the papers they came from.0 -
BMI was never meant to be conclusive as a singular metric. Saying it falls down as a singular metric doesn't disprove it. That's like saying the front leg on your tripod is useless because it won't hold up your camera on it's own.
BMI was meant to be a general guideline statistically and then taken into consideration along with other health indicators to get a complete picture on the individual level. You look at BMI, weight, BF %, waist measurement, waist to hip ratio, blood pressure, A1C, heart rate, lung sounds, etc and come to a conclusion. There are situations where one or two of those metrics might not be optimal but the rest are fine so you don't have to worry about it.
It's also important to remember that "health" is not a yes or no proposition, it's a sliding scale. There are myriad variables that make you more or less likely to get myriad conditions. All the BMI range is trying to do, is get you into a statistically lower risk category. Just like there are lifetime smokers who get to 90 and never get cancer, or people who drunk drive and don't get in an accident, you can live outside the healthy BMI range and be healthy. You just have a statistically higher risk, based on demographic data.
I'd say if you are above the healthy BMI range, and don't want or think you need to get lower, focus on the other metrics. If the other metrics are also out of line, then you might want to reconsider your perception of health, or you might be fine just consciously accepting the additional risk you are taking on. You get to choose, though I suppose your insurance company might make you pay for that choice.
I think whoever invented BMI is stalking this topic and hitting “disagree” with any comment that doesn’t worship BMI.
Your comment was perfectly reasoned on all fronts. Anyone disagreeing is either a willful troll or someone who is not qualified to sit at the adult table.
@Azdak given your background in the industry from your observations are there really many people that are obese on the BMI scale and not obese on a measure of bodyfat? I'm guessing a few athletes and maybe another unicorn or 2 but thinking not many given our sedentary society.
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zebasschick wrote: »BMI was never meant to be conclusive as a singular metric. Saying it falls down as a singular metric doesn't disprove it. That's like saying the front leg on your tripod is useless because it won't hold up your camera on it's own.
BMI was meant to be a general guideline statistically and then taken into consideration along with other health indicators to get a complete picture on the individual level. You look at BMI, weight, BF %, waist measurement, waist to hip ratio, blood pressure, A1C, heart rate, lung sounds, etc and come to a conclusion. There are situations where one or two of those metrics might not be optimal but the rest are fine so you don't have to worry about it.
It's also important to remember that "health" is not a yes or no proposition, it's a sliding scale. There are myriad variables that make you more or less likely to get myriad conditions. All the BMI range is trying to do, is get you into a statistically lower risk category. Just like there are lifetime smokers who get to 90 and never get cancer, or people who drunk drive and don't get in an accident, you can live outside the healthy BMI range and be healthy. You just have a statistically higher risk, based on demographic data.
I'd say if you are above the healthy BMI range, and don't want or think you need to get lower, focus on the other metrics. If the other metrics are also out of line, then you might want to reconsider your perception of health, or you might be fine just consciously accepting the additional risk you are taking on. You get to choose, though I suppose your insurance company might make you pay for that choice.
i totally agree with that, however several of my doctors and a nurse practitioner doesn't seem to have gotten the memo. all of them strongly believe in BMI as the one and only metric they're concerned with. this was a problem for me when i was a bodybuilder with some fat on me, and is one of the reasons i kept changing doctors.
my current doctor actually seems to agree with what you just wrote, btw.
Exactly, and this is my predominant issue with the use of BMI.
It is not correct/accurate/perfect for everyone, but is very often the only metric used to judge a persons weight/health. In my case it is flawed.
Could be a geographical divide here, Im in the UK - we dont get regular blood work done, things like that, so BMI is often the only real "test" applied.
I get the impression that in the States things like blood work are much more common.2 -
samhennings wrote: »zebasschick wrote: »BMI was never meant to be conclusive as a singular metric. Saying it falls down as a singular metric doesn't disprove it. That's like saying the front leg on your tripod is useless because it won't hold up your camera on it's own.
BMI was meant to be a general guideline statistically and then taken into consideration along with other health indicators to get a complete picture on the individual level. You look at BMI, weight, BF %, waist measurement, waist to hip ratio, blood pressure, A1C, heart rate, lung sounds, etc and come to a conclusion. There are situations where one or two of those metrics might not be optimal but the rest are fine so you don't have to worry about it.
It's also important to remember that "health" is not a yes or no proposition, it's a sliding scale. There are myriad variables that make you more or less likely to get myriad conditions. All the BMI range is trying to do, is get you into a statistically lower risk category. Just like there are lifetime smokers who get to 90 and never get cancer, or people who drunk drive and don't get in an accident, you can live outside the healthy BMI range and be healthy. You just have a statistically higher risk, based on demographic data.
I'd say if you are above the healthy BMI range, and don't want or think you need to get lower, focus on the other metrics. If the other metrics are also out of line, then you might want to reconsider your perception of health, or you might be fine just consciously accepting the additional risk you are taking on. You get to choose, though I suppose your insurance company might make you pay for that choice.
i totally agree with that, however several of my doctors and a nurse practitioner doesn't seem to have gotten the memo. all of them strongly believe in BMI as the one and only metric they're concerned with. this was a problem for me when i was a bodybuilder with some fat on me, and is one of the reasons i kept changing doctors.
my current doctor actually seems to agree with what you just wrote, btw.
Exactly, and this is my predominant issue with the use of BMI.
It is not correct/accurate/perfect for everyone, but is very often the only metric used to judge a persons weight/health. In my case it is flawed.
Could be a geographical divide here, Im in the UK - we dont get regular blood work done, things like that, so BMI is often the only real "test" applied.
I get the impression that in the States things like blood work are much more common.
Disagree with the bolded (I'm in the UK too). Going solely by BMI is contrary to the NHS's own guidelines.
From the NHS website - "You can use your BMI result as a starting point for further discussion with a GP about your weight and general health."
Now to me that sounds a very sensible way to use a simple and free tool that gives a reasonable guideline to the majority.
That Doctors and other medics are of a variable standard isn't unique to the UK.
That tools are misunderstood and misused is also far too common.17 -
samhennings wrote: »zebasschick wrote: »BMI was never meant to be conclusive as a singular metric. Saying it falls down as a singular metric doesn't disprove it. That's like saying the front leg on your tripod is useless because it won't hold up your camera on it's own.
BMI was meant to be a general guideline statistically and then taken into consideration along with other health indicators to get a complete picture on the individual level. You look at BMI, weight, BF %, waist measurement, waist to hip ratio, blood pressure, A1C, heart rate, lung sounds, etc and come to a conclusion. There are situations where one or two of those metrics might not be optimal but the rest are fine so you don't have to worry about it.
It's also important to remember that "health" is not a yes or no proposition, it's a sliding scale. There are myriad variables that make you more or less likely to get myriad conditions. All the BMI range is trying to do, is get you into a statistically lower risk category. Just like there are lifetime smokers who get to 90 and never get cancer, or people who drunk drive and don't get in an accident, you can live outside the healthy BMI range and be healthy. You just have a statistically higher risk, based on demographic data.
I'd say if you are above the healthy BMI range, and don't want or think you need to get lower, focus on the other metrics. If the other metrics are also out of line, then you might want to reconsider your perception of health, or you might be fine just consciously accepting the additional risk you are taking on. You get to choose, though I suppose your insurance company might make you pay for that choice.
i totally agree with that, however several of my doctors and a nurse practitioner doesn't seem to have gotten the memo. all of them strongly believe in BMI as the one and only metric they're concerned with. this was a problem for me when i was a bodybuilder with some fat on me, and is one of the reasons i kept changing doctors.
my current doctor actually seems to agree with what you just wrote, btw.
Exactly, and this is my predominant issue with the use of BMI.
It is not correct/accurate/perfect for everyone, but is very often the only metric used to judge a persons weight/health. In my case it is flawed.
Could be a geographical divide here, Im in the UK - we dont get regular blood work done, things like that, so BMI is often the only real "test" applied.
I get the impression that in the States things like blood work are much more common.
Disagree with the bolded (I'm in the UK too). Going solely by BMI is contrary to the NHS's own guidelines.
From the NHS website - "You can use your BMI result as a starting point for further discussion with a GP about your weight and general health."
Now to me that sounds a very sensible way to use a simple and free tool that gives a reasonable guideline to the majority.
That Doctors and other medics are of a variable standard isn't unique to the UK.
That tools are misunderstood and misused is also far too common.
I can only tell you how I see it used/implemented/spoke of.
And while that is a very sensible way of looking at it, its not necessarily how its used in the real world.
Just look on here at the number of people slavishly trying to fit into that BMI range, and stressing about whether they will/wont make it. Or the number of people who are having their doctors take BMI as an absolute and telling them to fit...
My intent in this thread in the first place was to try and illustrate how it isnt the be all/end all, and is in fact fallible.
Considering the worry and stress it brings to people I thought it was a pertinent point to make. That was all.
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samhennings wrote: »samhennings wrote: »zebasschick wrote: »BMI was never meant to be conclusive as a singular metric. Saying it falls down as a singular metric doesn't disprove it. That's like saying the front leg on your tripod is useless because it won't hold up your camera on it's own.
BMI was meant to be a general guideline statistically and then taken into consideration along with other health indicators to get a complete picture on the individual level. You look at BMI, weight, BF %, waist measurement, waist to hip ratio, blood pressure, A1C, heart rate, lung sounds, etc and come to a conclusion. There are situations where one or two of those metrics might not be optimal but the rest are fine so you don't have to worry about it.
It's also important to remember that "health" is not a yes or no proposition, it's a sliding scale. There are myriad variables that make you more or less likely to get myriad conditions. All the BMI range is trying to do, is get you into a statistically lower risk category. Just like there are lifetime smokers who get to 90 and never get cancer, or people who drunk drive and don't get in an accident, you can live outside the healthy BMI range and be healthy. You just have a statistically higher risk, based on demographic data.
I'd say if you are above the healthy BMI range, and don't want or think you need to get lower, focus on the other metrics. If the other metrics are also out of line, then you might want to reconsider your perception of health, or you might be fine just consciously accepting the additional risk you are taking on. You get to choose, though I suppose your insurance company might make you pay for that choice.
i totally agree with that, however several of my doctors and a nurse practitioner doesn't seem to have gotten the memo. all of them strongly believe in BMI as the one and only metric they're concerned with. this was a problem for me when i was a bodybuilder with some fat on me, and is one of the reasons i kept changing doctors.
my current doctor actually seems to agree with what you just wrote, btw.
Exactly, and this is my predominant issue with the use of BMI.
It is not correct/accurate/perfect for everyone, but is very often the only metric used to judge a persons weight/health. In my case it is flawed.
Could be a geographical divide here, Im in the UK - we dont get regular blood work done, things like that, so BMI is often the only real "test" applied.
I get the impression that in the States things like blood work are much more common.
Disagree with the bolded (I'm in the UK too). Going solely by BMI is contrary to the NHS's own guidelines.
From the NHS website - "You can use your BMI result as a starting point for further discussion with a GP about your weight and general health."
Now to me that sounds a very sensible way to use a simple and free tool that gives a reasonable guideline to the majority.
That Doctors and other medics are of a variable standard isn't unique to the UK.
That tools are misunderstood and misused is also far too common.
I can only tell you how I see it used/implemented/spoke of.
And while that is a very sensible way of looking at it, its not necessarily how its used in the real world.
Just look on here at the number of people slavishly trying to fit into that BMI range, and stressing about whether they will/wont make it. Or the number of people who are having their doctors take BMI as an absolute and telling them to fit...
My intent in this thread in the first place was to try and illustrate how it isnt the be all/end all, and is in fact fallible.
Considering the worry and stress it brings to people I thought it was a pertinent point to make. That was all.
I agree with ur post, which was what I was trying to convey through my posts toward BMI. Although many disagreed with the way I felt about the use of the tool and the way I feel about the label Morbid obesity, it's interesting to see people's perceptions.3 -
samhennings wrote: »samhennings wrote: »zebasschick wrote: »BMI was never meant to be conclusive as a singular metric. Saying it falls down as a singular metric doesn't disprove it. That's like saying the front leg on your tripod is useless because it won't hold up your camera on it's own.
BMI was meant to be a general guideline statistically and then taken into consideration along with other health indicators to get a complete picture on the individual level. You look at BMI, weight, BF %, waist measurement, waist to hip ratio, blood pressure, A1C, heart rate, lung sounds, etc and come to a conclusion. There are situations where one or two of those metrics might not be optimal but the rest are fine so you don't have to worry about it.
It's also important to remember that "health" is not a yes or no proposition, it's a sliding scale. There are myriad variables that make you more or less likely to get myriad conditions. All the BMI range is trying to do, is get you into a statistically lower risk category. Just like there are lifetime smokers who get to 90 and never get cancer, or people who drunk drive and don't get in an accident, you can live outside the healthy BMI range and be healthy. You just have a statistically higher risk, based on demographic data.
I'd say if you are above the healthy BMI range, and don't want or think you need to get lower, focus on the other metrics. If the other metrics are also out of line, then you might want to reconsider your perception of health, or you might be fine just consciously accepting the additional risk you are taking on. You get to choose, though I suppose your insurance company might make you pay for that choice.
i totally agree with that, however several of my doctors and a nurse practitioner doesn't seem to have gotten the memo. all of them strongly believe in BMI as the one and only metric they're concerned with. this was a problem for me when i was a bodybuilder with some fat on me, and is one of the reasons i kept changing doctors.
my current doctor actually seems to agree with what you just wrote, btw.
Exactly, and this is my predominant issue with the use of BMI.
It is not correct/accurate/perfect for everyone, but is very often the only metric used to judge a persons weight/health. In my case it is flawed.
Could be a geographical divide here, Im in the UK - we dont get regular blood work done, things like that, so BMI is often the only real "test" applied.
I get the impression that in the States things like blood work are much more common.
Disagree with the bolded (I'm in the UK too). Going solely by BMI is contrary to the NHS's own guidelines.
From the NHS website - "You can use your BMI result as a starting point for further discussion with a GP about your weight and general health."
Now to me that sounds a very sensible way to use a simple and free tool that gives a reasonable guideline to the majority.
That Doctors and other medics are of a variable standard isn't unique to the UK.
That tools are misunderstood and misused is also far too common.
I can only tell you how I see it used/implemented/spoke of.
And while that is a very sensible way of looking at it, its not necessarily how its used in the real world.
Just look on here at the number of people slavishly trying to fit into that BMI range, and stressing about whether they will/wont make it. Or the number of people who are having their doctors take BMI as an absolute and telling them to fit...
My intent in this thread in the first place was to try and illustrate how it isnt the be all/end all, and is in fact fallible.
Considering the worry and stress it brings to people I thought it was a pertinent point to make. That was all.
Given that BMI is a fairly good indicator of weigh issues that can have a negative impact on health, maybe it's a good thing they are paying attention to it.
I am in the overweight category, about 26.5. I have also done resistance training on a consistent basis since I was a teenager. In my annual physical with a company doctor (who rotate so seldom see the same person) they all mention my BMI since it is part of the standard set of things the measure. All of them have told me that my weight is fine due to lower BF%. Not a one has told me to lose weight.9 -
Theoldguy1 wrote: »samhennings wrote: »samhennings wrote: »zebasschick wrote: »BMI was never meant to be conclusive as a singular metric. Saying it falls down as a singular metric doesn't disprove it. That's like saying the front leg on your tripod is useless because it won't hold up your camera on it's own.
BMI was meant to be a general guideline statistically and then taken into consideration along with other health indicators to get a complete picture on the individual level. You look at BMI, weight, BF %, waist measurement, waist to hip ratio, blood pressure, A1C, heart rate, lung sounds, etc and come to a conclusion. There are situations where one or two of those metrics might not be optimal but the rest are fine so you don't have to worry about it.
It's also important to remember that "health" is not a yes or no proposition, it's a sliding scale. There are myriad variables that make you more or less likely to get myriad conditions. All the BMI range is trying to do, is get you into a statistically lower risk category. Just like there are lifetime smokers who get to 90 and never get cancer, or people who drunk drive and don't get in an accident, you can live outside the healthy BMI range and be healthy. You just have a statistically higher risk, based on demographic data.
I'd say if you are above the healthy BMI range, and don't want or think you need to get lower, focus on the other metrics. If the other metrics are also out of line, then you might want to reconsider your perception of health, or you might be fine just consciously accepting the additional risk you are taking on. You get to choose, though I suppose your insurance company might make you pay for that choice.
i totally agree with that, however several of my doctors and a nurse practitioner doesn't seem to have gotten the memo. all of them strongly believe in BMI as the one and only metric they're concerned with. this was a problem for me when i was a bodybuilder with some fat on me, and is one of the reasons i kept changing doctors.
my current doctor actually seems to agree with what you just wrote, btw.
Exactly, and this is my predominant issue with the use of BMI.
It is not correct/accurate/perfect for everyone, but is very often the only metric used to judge a persons weight/health. In my case it is flawed.
Could be a geographical divide here, Im in the UK - we dont get regular blood work done, things like that, so BMI is often the only real "test" applied.
I get the impression that in the States things like blood work are much more common.
Disagree with the bolded (I'm in the UK too). Going solely by BMI is contrary to the NHS's own guidelines.
From the NHS website - "You can use your BMI result as a starting point for further discussion with a GP about your weight and general health."
Now to me that sounds a very sensible way to use a simple and free tool that gives a reasonable guideline to the majority.
That Doctors and other medics are of a variable standard isn't unique to the UK.
That tools are misunderstood and misused is also far too common.
I can only tell you how I see it used/implemented/spoke of.
And while that is a very sensible way of looking at it, its not necessarily how its used in the real world.
Just look on here at the number of people slavishly trying to fit into that BMI range, and stressing about whether they will/wont make it. Or the number of people who are having their doctors take BMI as an absolute and telling them to fit...
My intent in this thread in the first place was to try and illustrate how it isnt the be all/end all, and is in fact fallible.
Considering the worry and stress it brings to people I thought it was a pertinent point to make. That was all.
Given that BMI is a fairly good indicator of weigh issues that can have a negative impact on health, maybe it's a good thing they are paying attention to it.
I am in the overweight category, about 26.5. I have also done resistance training on a consistent basis since I was a teenager. In my annual physical with a company doctor (who rotate so seldom see the same person) they all mention my BMI since it is part of the standard set of things the measure. All of them have told me that my weight is fine due to lower BF%. Not a one has told me to lose weight.
Sounds like you are under good care then.
Also sounds like you arent someone overly worrying about BMI or bodyweight, so really my post was never intended for you.
I have no issue at all with BMI being a metric among many, as part of a whole, and something used as indicative and not absolute.
I have issue with it being used as THE SINGLE metric, as it often is, because its too fallible for that.4 -
Theoldguy1 wrote: »BMI was never meant to be conclusive as a singular metric. Saying it falls down as a singular metric doesn't disprove it. That's like saying the front leg on your tripod is useless because it won't hold up your camera on it's own.
BMI was meant to be a general guideline statistically and then taken into consideration along with other health indicators to get a complete picture on the individual level. You look at BMI, weight, BF %, waist measurement, waist to hip ratio, blood pressure, A1C, heart rate, lung sounds, etc and come to a conclusion. There are situations where one or two of those metrics might not be optimal but the rest are fine so you don't have to worry about it.
It's also important to remember that "health" is not a yes or no proposition, it's a sliding scale. There are myriad variables that make you more or less likely to get myriad conditions. All the BMI range is trying to do, is get you into a statistically lower risk category. Just like there are lifetime smokers who get to 90 and never get cancer, or people who drunk drive and don't get in an accident, you can live outside the healthy BMI range and be healthy. You just have a statistically higher risk, based on demographic data.
I'd say if you are above the healthy BMI range, and don't want or think you need to get lower, focus on the other metrics. If the other metrics are also out of line, then you might want to reconsider your perception of health, or you might be fine just consciously accepting the additional risk you are taking on. You get to choose, though I suppose your insurance company might make you pay for that choice.
I think whoever invented BMI is stalking this topic and hitting “disagree” with any comment that doesn’t worship BMI.
Your comment was perfectly reasoned on all fronts. Anyone disagreeing is either a willful troll or someone who is not qualified to sit at the adult table.
@Azdak given your background in the industry from your observations are there really many people that are obese on the BMI scale and not obese on a measure of bodyfat? I'm guessing a few athletes and maybe another unicorn or 2 but thinking not many given our sedentary society.
I’ve addressed this before and I try to be scrupulously honest and calibrated in my responses since there are a lot of opinions on this topic.
First, I don’t have any actual numbers on how many people fall outside the “normal” range of BMI.
I have my own bias in that I have the education, experience, and tools to measure and interpret actual body fat readings. Unless it’s an outlier, I have a tendency to ignore BMI altogether. That’s not meant to be boastful-it’s actually probably a bad habit on my part.
I have seen references to 15% or more of the population who don’t fit the standard BMI ranges. My anecdotal observations fit with that. It doesn’t sound like much, but it’s more than you think. And these are “normal” folks—not athletes or bodybuilders, or even recreational lifters.
I see as many, if not more, people in the low BMI (ie normal BMI/higher body fat) category as in the higher one (high BMI/low body fat)—especially women.
The numbers skew a little more when people start weight loss programs in our gym. That is because they always have a lifting component. And they don’t realize huge gains in muscle mass, it’s enough that it would be discouraging if all they relied on was the scale or BMI to interpret results.
That’s as honest as I can be. I’m not as dismissive of BMI as some in my profession because I understand its uses as well as its limitations. But I am wary of the fact that so many medical and health professionals rely on it exclusively and use it as an absolute measure. While not a large number, there are still enough “normal” people who fall outside the range that the average doctor is going to see 10 or 15 per week.2 -
as a health professional, I agree that a number of 'normal' people fall outside the standard range - particulalry tall sporty young men. Not elite body builders, just general young sporty types.
Have said this on here many times.
However by outside the range ,I mean with BMI's of around 27, 28 - not massively outside the range.
I would be very surprised if any doctors told such men to lose weight or that their weight was an issue.
On the flip side, I would be very surprised if anyone were concerned abut a petite asian lady having a BMI of just under 18,
Context and degree matters.14 -
If I could ‘like’ the above post 100 times I would!
Context and common sense in this, like in so many things in life are so much more important than nitpicking about ‘outliers’ or ‘not outliers’.6 -
I'd guess this also ties in a LOT with a common issue we mention here - that your average doctor and nurse is woefully under educated in weight maintenance. They may very well rely too heavily on this one metric because they simply don't understand the context in the first place, or be forced to rely too heavily on it by a bureaucracy that doesn't understand it. Adding in that the average person is also uneducated in weight maintenance, and you have a problem.
I do still believe that there are far more people who need to lose weight but think they are big boned or muscular that dismiss BMI, than there are fit muscular people who are unnecessarily concerned or harassed by their doctor who are legit outliers, but I could be wrong. And even so, that's not an indictment of the metric, it's an indictment of how it's used. It doesn't change its usefulness as a general guideline for the average person. It just requires some nuance for fit people in the slightly overweight range, and possibly for women at the high end of the healthy range (who if they are not fit, might still be slightly over-fat).10 -
I do still believe that there are far more people who need to lose weight but think they are big boned or muscular that dismiss BMI, than there are fit muscular people who are unnecessarily concerned or harassed by their doctor who are legit outliers, but I could be wrong.
Absolutely.
I find it hard to believe that many people are harassed by their doctor because they are slightly outside the standard range when they are clearly the type of person for whom such is ok - eg the examples i gave above.
heck i doubt doctors harass people who are actually over weight just outside the range - when I had a BMI of 28 as a middle aged not particularly fit or muscular woman - my BMI of 28 was plain old over weight but Nobody hassled me at all - it was overweight but not in the dangerous or obese level and I had no co morbidities that would make being that level of overweight a significant risk.
Like kimmy, I think there are far more people who use this 'But there are outliers' to consider themself an outlier whose BMI does not really reflect being overweight when in fact it does.
Case in point: OP.
Highly unlikely that a non body building woman with BMI over 30 is not really overweight, bordering on obese.16 -
paperpudding wrote: »as a health professional, I agree that a number of 'normal' people fall outside the standard range - particulalry tall sporty young men. Not elite body builders, just general young sporty types.
Have said this on here many times.
However by outside the range ,I mean with BMI's of around 27, 28 - not massively outside the range.
I would be very surprised if any doctors told such men to lose weight or that their weight was an issue.
On the flip side, I would be very surprised if anyone were concerned abut a petite asian lady having a BMI of just under 18,
Context and degree matters.
Absolutely agree. Do you come across many people in practise with a healthy BMI but a lot of visceral fat around their waist? I work in a GP setting in Australia and waist measurements are used more so in risk assessment tools when doing health assessments than BMI. Just interested to see if that is the case for you in your health setting where you're from.0 -
No, not really.
I don't come across a lot of people with healthy range BMI but high waist measurements.
On the contrary, I come across many healthy young men with slightly high BMI's but healthy range waist measurements ( the types I mentioned above.)
But I do a lot of pre employment medicals for industrial jobs - and young fit men are the main demographic of them.
I also come across many people in other areas of the job who have high BMI and over healthy range waist measurements - have not had one of those yet who I would say that does not accurately show overweight.4 -
My doctor looks at frame size, BMI, hip/waist ratio, and lipid profile. BMI is only a part of the equation when looking at overall health.
That said there is an entire overweight range on the BMI chart between normal and obese. It’s much more likely someone can be healthy and at low health risk in the overweight category than the obese one.
12 -
That said there is an entire overweight range on the BMI chart between normal and obese. It’s much more likely someone can be healthy and at low health risk in the overweight category than the obese one.
yes of course.
Thats what I meant by a matter of degree.
Obviously the risk for anyone of having a BMI of, say. 28, is different to the risk of one of 45.3 -
Interesting that most here advise talking to your doctor. The doctors, nurses, techs, and receptionists at the clinic I go to are all, and I do mean ALL...obese. Morbidly obese.0
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